Laparoscopic mesh repair of parahiatal hernia: A case report

Lew, Pei Shi; Wong, Andrew Siang Yih

doi:10.1111/ases.12039

Cited by 12 publications

(10 citation statements)

References 7 publications

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“…The search identified 16 relevant articles published in the language of English. [1][2][3][4][5][8][9][10][11][12][13][14][15][16][17] Together with two cases from our clinical work, a total of 27 parahiatal hernia patients were included in the present study; 15 cases were female, 12 cases were male, the average age was 51.8 years old (range: 4-80 years old). The overview and summarized data are presented in Tables 1 and 2, respectively.…”

Section: Resultsmentioning

confidence: 99%

Another type of diaphragmatic hernia to remember: parahiatal hernia

Guo

Shao

et al. 2020

ANZ Journal of Surgery

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Background: Parahiatal hernia is a less common form of diaphragmatic hernia, with the defect lateral to the crus and oesophageal hiatus, and the unfamiliarity of this disease would cause confusion to general surgeons. In the present study, the literature on parahiatal hernia were reviewed, the clinical profile of this disease, as well as our own experience is presented and analysed. Methods: In the present study, a thorough identification of all published reports on parahiatal hernias was made, together with our own cases, the available data were summarized, analysed and discussed. Results: A total of 27 cases of parahiatal hernias were identified since 1987. Among them, 19 cases were primary parahiatal hernias, and eight cases were secondary or acquired parahiatal hernias. None of the 27 cases were pre-operatively diagnosed, and the majority of them were pre-operatively diagnosed as paraoesophageal hernias. Detailed treatment data were available in 26 of the 27 cases. Three patients received open surgery, and 23 patients were treated with laparoscopic procedures. Suture repair was used in 12 cases, and 14 cases were repaired with mesh reinforcement. In addition, two cases underwent partial gastrectomy, stomach suture was performed in another two cases. Conclusion: Patients with parahiatal hernia have a high risk of developing hernia incarceration or gastric vovulus. Laparoscopic treatment of parahiatal hernia is feasible and safe in the majority cases. Surgeons should be aware of this disease when performing paraoesophageal hernia repair, as parahiatal hernias may occur with or without previous diaphragmatic surgery.

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Section: Resultsmentioning

confidence: 99%

Another type of diaphragmatic hernia to remember: parahiatal hernia

Guo

Shao

et al. 2020

ANZ Journal of Surgery

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“…The array of symptoms it can cause is wide, making it almost impossible to suspect clinically[1,4,5].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding mesh reinforcement, it was added in 7 cases out of 14 analyzed in our review. Some authors report a fibrous ring around the defect that make its closure difficult with just sutures, and thus a mesh can be added to reinforce the closure or a mesh repair can be performed[1,7,8].…”

Section: Discussionmentioning

confidence: 99%

“…Because of its close relation to the hiatus, similar symptom presentation, imagistic findings and treatment, most authors include this type of diaphragmatic hernia with hiatal hernia, while other authors consider them as a rare variant of paraesophageal hernias[1]. From an ethiopathogenic standpoint, PHHs can be classified as either primary or secondary to a surgical intervention that involved the hiatal orifice as in esophagectomies, esogastrectomies, Heller myotomy, or any other intervention that involves manipulation of the hiatus.…”

Section: Introductionmentioning

confidence: 99%

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Primary parahiatal hernias: A case report and review of the literature

Preda

Pătrașcu

Ungureanu

et al. 2019

WJCC

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BACKGROUNDParahiatal hernias (PHHs) are rare occurring disease, with a reported incidence of 0.2%-0.35% in patients undergoing surgery for hiatal hernia. We found only a handful of cases of primary PHHs in the literature. The aim of this paper is to present a case of a primary PHH and perform a systematic review of the literature.CASE SUMMARYWe report the case of a 60-year-old Caucasian woman with no history of thoraco-abdominal surgery or trauma, which accused epigastric pain, starting 2 years prior, pseudo-angina and bloating. Based on imagistic findings the patient was diagnosed with a PHH and an associated type I hiatal hernia. Patient underwent laparoscopic surgery and we found an opening in the diaphragm of 7 cm diameter, lateral to the left crus, through which 40%-50% of the stomach had herniated in the thorax, and a small sliding hiatal hernia with an anatomically intact hiatal orifice but slightly enlarged. We performed closure of the defect, suture hiatoplasty and a “floppy” Nissen fundoplication. Postoperative outcome was uneventful, with the patient discharged on the fifth postoperative day. We performed a review of the literature and identified eight articles regarding primary PHH. All data was compiled into one tabled and analyzed.CONCLUSIONPrimary PHHs are rare entities, with similar clinical and imagistic findings with paraesophageal hernias. Treatment usually includes laparoscopic approach with closure of the defect and the esophageal hiatus should be dissected and analyzed. Postoperative outcome is favorable in all cases reviewed and no recurrence is cited in the literature.

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“…Upper gastrointestinal tract contrast studies and CT are the imaging modalities of choice. Stable patients with no evidence of perforation can be managed laparoscopically with repair of hernial defect,3 while unstable patients require urgent open intervention.

Learning points

Gastric volvulus is defined as an acquired 180° rotation of the stomach creating a closed loop obstruction.

Gastric volvulus can be classified based on the axis of rotation into organoaxial, mesenteroaxial and mixed types.

Stable patients with no evidence of perforation can be successfully managed laparoscopically.

…”

Section: Descriptionmentioning

confidence: 99%

Laparoscopic repair of large paraoesophageal hernia with totally intrathoracic stomach

et al. 2014

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Laparoscopic mesh repair of parahiatal hernia: A case report

Cited by 12 publications

References 7 publications

Another type of diaphragmatic hernia to remember: parahiatal hernia

Another type of diaphragmatic hernia to remember: parahiatal hernia

Primary parahiatal hernias: A case report and review of the literature

Laparoscopic repair of large paraoesophageal hernia with totally intrathoracic stomach

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